Health Information Exchange - Research Paper Example

Introduction The term health information exchange, or HIE, de s the process of sharing health related data among different organization in adherence to nationally recognized standards. To understand the concept, consider the following analogy: Imagine a patient X, is allergic to penicillin or any other antibiotic for that matter, patient X has lived all his life in Ohio and his doctor is well familiar with his condition hence never prescribes anything he is allergic to. Now suppose he travels to New York and while he is there he falls ill, and the doctors treating him include among other medication penicillin, the results could be fatal. This is one of the problems, which the Health Information Exchange system is meant to prevent and solve. Health information exchange is an IT initiative that seeks to improve the national health IT infrastructure in order to facilitate comprehensive and patient focused view of this information (“Health Information Exchange Resources”). The Health Information Exchange system is designed to facilitate mobilization of healthcare data electronically across the relative health organizations that may come to contact with members of the community (“Health Information Exchange Resources”). It allows electronic transfer of clinical information and is charged with the responsibility of protecting the data from unauthorized access and interference. This system also facilitates the retrieval of patient information in order to ensure quick and efficient patient centered and equitable healthcare. This system will ensure incidences like the aforementioned one are mitigated, and doctors anywhere can type the name of a patient anywhere in the country, and be supplied with all the information on their health history in order to ensure they respond as fast and effect as possible without endangering the patient’s life. This paper aims at providing a detailed description of the history of the American health information exchange, the rational and benefits as well as challenges facing the systems and proposed solutions. History The initiation of the healthcare information management system was spurred by several factors, pertinent among this was the need for a practical national healthcare reforms especially in view of the several unsuccessful attempts in the 90’s and 2000’s. One of the earliest attempts at HIE was in 1990 when the Hartford Foundation gave out several grants to different cities with the intention of creating a community health inflation management system (“History of the Health Information Exchange”). The grantees developed centralized data repositories containing patient data such as demographics and insurance eligibility; nonetheless, they were all unsuccessful primarily due to the poor development of the technological infrastructure at the time. Another attempt was made in the mid 90’s in the form of Health Information Networks” CHINs, they used decentralized data structure in order to protect client privacy, however, these were comprised entirely of competing companies, which were interested in profits, and most of them bailed when there was no clear return on investment. However, in the mid 2000’s the American government was becoming increasingly wary in the wake of concerns resulting from post 9/11 terrorist anthrax attacks and the need to provide a mechanism to provide surveillance and mitigation in case of bioterrorism threats in real. It was also encouraged by the need to facilitate proactively America’s ability to detect, and combat emerging epidemics such as avian flu SARs and West Nile virus among others. In due consideration for this and many other factors, President Bush initiated the system by creating the office of the National healthcare coordinator. This headed by Doctor Bailer, and it was the personification of the mutual desires of the nation and public to utilize and advance the growth of health information technology (HIT) and in the end reduce the cost of healthcare in the country (“Health Information Exchange Resources”). In 2005nthe Department of Health and Human Services through a committee contracted, several groups to develop information technology infrastructure that would lead to a comprehensive HIE. An 18 billion dollar grant was also awarded to Accenture; Computer Science Corporation (CSC), International Business Machines (IBM) and Northrop Grumman to develop architecture and technology that would ensure secure information sharing between hospitals laboratories and other relevant healthcare institutions. With the cooperation of the Bush administration, the results of these consortiums work was practically applied in several municipal and private foundations to form local versions of HIE and these later gained statewide and national application although the impanation is still an ongoing process (“History of the Health Information Exchange”). Rationale Despite consensuses among analysts and policy makers, that Health IT is a vital component of a better health system in the United States, many healthcare providers have been reluctant to apply it with only about 11 percent hospitals having adopted it by the year 2006. Nonetheless, the benefits of this system are unequivocal the system despite its shortcomings would be overall highly beneficial to both the medical practitioners and patients in any hospital. The following are some of the key benefits hence rationale for application of the Healthcare information management system. The number of duplicated diagnostic tests is bound to go down should many health institutions adopt the system. This is because when one goes to a hospital with symptoms of a disease for which they have been tested in the past but without the results on them, they needs must undergo the same test before the new physician can undertake to treat them. However, should such data be availed by the doctor, they will instantly know what problem the patient is suffering from without having to conduct the test themselves; which will increase the time efficiency of treatment. This will also reduce the expenses of treatment since many diagnostic tests are quite expensive, it is however, notable that many doctors might be demotivated from buying a HIE system by this since the elimination of duplicate tests will ultimate reduce their income. As aforementioned, patient history data is very important when it comes to treatment, as such, the HIE system will provide the doctors with a chance to update this in real time so that should the patient go elsewhere for medication, the new doctor will know exactly where to proceed from. Furthermore, when it comes to emergency cases such as those patients rushed to the casualty department, the doctors will save time since they will not have to spend it testing for things such as the patients’ blood group and drug allergies and hence give them a biter chance of survival. The physician would also be able to use a drop and click method to update the patient’s records hence eliminating the need for dictation or handwriting both which will result in savings both in time and money in the long run (Congressional Budget Office 5). The referral process will also be simplifies since the referring physician would automatically transfer pertinent patient data such as tests and medication administered to the patient. The specialist would then automatically transfer their data to the original doctor, and they will become part of the patients file. The use of HIE systems also results in savings both external and internal, the latter is realized when the institution using the system makes savings because of improved health delivery. On the other hand, external saving accrues to someone other than the hospital possible the insurance company, the government of even the patient. This has been proven, by two studies, one by the RAND cooperation and the other by the center for information technology leadership, both show that should all the medical institutions make us of the HIE system, savings in excess of 80 thousand dollars annually would accrue to the government(Congressional Budget Office 7). It is worth noting that, the system has other underlying benefits especially toward the environment since it involves reduced usage of paper and this ultimately translates to saving a few trees every time your doctor clicks a button instead of writing a prescription on a piece of paper. Security and Privacy Dilemmas One of the issues facing the systems is the dilemma that is privacy and the security of the patient’s data, in many ways, the system at its present does very little to control access to patients data. For instance in New York state, there is no system that allows one to control which provider can access what data and virtually any physician with the privileges to view your data can access every aspect of them even those that might have no bearing on the present condition(Shrink Rap News). Consider a hypothetical case of patient with a history of mental illness; such patient might prefer to have this information being confidential to prevent the stigma that is often associated with such condition. This can be mitigated in several ways; the currently available one is giving the patient an option of opting out, which would mean none of the data would be visible unless a patient supplied it to the doctor. This is, however, this is counterproductive since it will mean the patient is not befitting at all from the system in the first place. A proposed strategy to deal with this is to put safeguards on some of the data that is considered private such as HIV status, mental illness and drug abuse. However, this result in another dilemma that is, which conditions should be kept hidden and how the physicians will provide quality care with in cases where this might be pertinent to the problem being treated (Shrink Rap News). Challenges In addition to the security and privacy dilemmas above, the system has been encumbered by a myriad of challenges. One of the major challenges include, overcrowding of data and because of the many exchanges that are being formed every day. This has lead shortage of staff to deal with the ICT related aspect of it all. These problems can be solved by investing in the latest technology and training the staff who are working with the system for optimum productivity. For instance, the state of Massachusetts has invested in incentives, and the latest broadband technology to prop up the systems. Insufficient funding has however made it difficult for implementation of HIE; despite getting large amounts of money for the program, in states like New Jersey, the dense population is making the amounts seem insignificant and hence the crippling implementation of HIE (Gamble). This can be solved if the government was to work closely with the states and ensure that they do not just get money arbitrarily, but to take keep track of the logistics on the ground at first before allocating money to avoid incomplete projects. Slow implementation because, in many ways, the system is still in its experimental stages and not fully developed, many firms are reluctant to invests in it now in its incomplete stage since this will might require they purchase the final product when it is developed in the future. This was solved by service based EHR vendors offering low cost migration and quick deployment before the 2011 deadline; therefore, they could collect their reimbursement (Horwitt). As aforementioned, it makes more financial sense in the short run and sometimes in the long run too for doctors to invest in testing equipment than HIE equipment. This has contributed to many medical practitioners being reluctant to make use of technology, to mitigate this, the government should put up in place measures to compensate the doctors for using the technology since the government stands to benefit in the end. Conclusion In view of the facts presented, it is evident that the potential portended by the use of HIE systems in the United States cannot be overstated. The Obama administration continues developing the blue prints developed and if the implementation is successful, the American medical system will be much more efficient not to mention the benefits in national security because of real-time medical updates. Technology has been used to develop service delivery in a many fields with remarkable improvements, and the same has applied to medicine. Service delivery stands to be improved an ultimately financial gains are in the offing especially for the government which indirectly translates to the citizens. However, security and privacy concerns have made many people reluctant to apply this technology; nonetheless these and other challenges are being continuously addressed since the benefits of HIE clearly exceed the shortcoming it might have. Works Cited “Health Information Exchange Resources”. American Healthcare Information Management. n.d. Web 14 October 2012. “History of the Health Information Exchange (HIE)” Long Island Patient Information Exchange LIPIX. n.d. Web. 14 October 2012 Congressional Budget Office. “Evidence on the Costs and Benefits of Health Information Technology”. 2008. Web. 14 October 2012. Gamble, Kate. “HIEs and the Funding Dilemma” HealthCare Informatics. May 3, 2010. Web 14 October 2012. Horwitt Elisabeth. “Lack of health information exchange standards slowing adoption” Search Health IT. 2009. Web. 14 October 2012. Shrink Rap News. “Sensitive Health Data, State Health Information Exchanges: Dilemmas Prevail”. Clinical Psychiatry news. July 5 2011. 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